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December 5, 2011

5 Top Challenges in the Hospital OR — And How to Overcome Them

Operating rooms present hospital leaders with many challenges, from maintaining infection control standards to staying on schedule to communicating as a team.  Lucas Higman, Vice President of Soyring Consulting, shares the five biggest challenges of an OR and how hospital leaders can overcome them.

1. Block scheduling. 
Mr. Higman says one of the key strategies to block scheduling is gaining support from hospital administration, as aligning hospital executives' goals with OR leaders' goals is critical when facing physicians who are unsatisfied with their block scheduling arrangement.  "Inevitably the physicians who [lose block time due to underutilization] may go straight to the top to voice their opinions," he says.

Another strategy for addressing block scheduling is to allow surgeons to release block time if they are unable to use it.  Instead of blocking 100 percent of the day, permitting release time can accommodate add-on cases and potentially increase the number of cases an OR can perform in the same amount of time, Mr. Higman says.

2. Physician preference.  Mr. Higman says standardization does not necessarily mean the hospital has to choose one vendor or one product, but decreasing the number to two, for example, can still go a long way in lowering costs and improving supply chain efficiency.

"Vendors are willing to work with you to give you a better price because they may be able to increase their volume of sales," Mr. Higman says.  "The key is maintaining compliance with the [vendor's] contract and having mechanisms in place within the material management system to maintain obligations."

3. Turnover.  Mr. Higman says taking a team approach to turnover can help OR managers overcome these challenges.  He suggests anesthesia providers and surgeons join the nursing, tech, support, and housekeeping staff in cleaning the OR because it can speed the process and improve morale.  "[Having] the highest person on the totem pole within that room leading the charge [can make] everyone motivated to move quickly and get the next patient in."

4. Organizational structure.  The optimal organizational structure will vary depending on the particular hospital.  Thus, one of the first steps in developing a strong structure is identifying the organization's needs, resources, and size.  ORs can determine the number of service lines to create by assessing whether the volume for each service is sufficient to warrant a separate service line and if there are enough staff with the necessary skills who are willing to perform these services, Mr. Higman says.

5. First case starts.  Mr. Higman says the OR should define what a first-case start is.  He suggests using the time the patient is in the room as the start.  To ensure the first case starts on time, the OR needs to have all preoperative testing and preparation completed before the day of the surgery.  OR staff need to communicate with each patient before their surgery to complete the necessary paperwork and screening needed for the surgical case.

"There are things that are outside the facility's control, but the patient process and preoperative preparation are two factors that a facility can control and improve."

Read the full article from Becker's Hospital Review.

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